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Objective: To discuss the clinic features and diagnosis of one case of hepatic angiomyolipoma (HAML), and to analyze and summarize its diagnosis and treatment methods. Methods: The clinical materials of one case of HAML patient who was misdiagnosised as hepatocellular carcinoma were analyzed retrospectively, and the related literatures were reviewed. Results: A middle-aged female patient visited our outpatient service because of low back discomfort. The upper abdominal CT and MRI suggested that a space occupying lesion located at the left lobe of liver inner lower segment, considering a high possibility of hepatocellular carcinoma. The patient underwent the left lobe of inner lower segmentectomy. The postoperative histopathological examination and immunohistochemical staining showed the tumour was HAML, After operation, the patient recovered well and the follow-up examination after hepatectomy found no tumor recurrence. Conclusion: HAML has no specific clinical characteristics or imaging features. The diagnosis of HAML mostly depend on the histopathological examination and hepatectomy is the effective treatment.
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Objective:To discuss the clinic features and diagnosis of one case of hepatic angiomyolipoma (HAML) , and to analyze and summarize its diagnosis and treatment methods.Methods:The clinical materials of one case of HAML patient who was misdiagnosised as hepatocellcular carcinoma were analyzed retrospectively, and the related literatures were reviewed.Results:A middle-aged female patient visited our outpatient service because of low back discomfort.The upper abdominal CT and MRI suggested that a space occupying lesion located at the left lobe of liver inner lower segment, considering a high possibility of hepatocellular carcinoma.The patient underwent the left lobe of inner lower segmentectomy.The postoperative histopathological examination and immunohistochemical staining showed the tumour was HAML, After operation, the patient recovered well and the follow-up examination after hepatectomy found no tumor recurrence.Conclusion:HAML has no specific clinical characteristics or imaging features.The diagnosis of HAML mostly depend on the histopathological examination and hepatectomy is the effective treatment.
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Objective To compare the MRI manifestations and characteristics of ≤ 3 cm nonepithelial hepatic angiomyolipomas (HAML)and small hepatocellular carcinoma (SHCC),then improve the preoperative diagnostic accuracy.Methods A retrospective analysis of 20 patients ≤3 cm nonepithelial HAML and 26 cases of SHCC,confirmed by clinical pathology,with both in clinical data and MRI characteristics.Results ≤3 cm nonepithelial HAML commonly occurs in women;The enhancement patterns“wash in and wash out”in 1 1 cases,6 cases “wash in but slow out”,3 cases with delayed enhancement;Mature adipose tissue found in 5 cases, 3 cases has pseudocapsule enhancemen in delayed phase,13 cases can see central vessels;While SHCC often occurs in men,with“wash in and wash out”enhancement pattern in 23 cases,1 7 cases with pseudocapsule enhancemen in delayed phase,12 cases can see central vessels in lesions.ADC values for SHCC was significantly lower than that for ≤3 cm nonepithelial HAML,the ADC values of SHCC significantly lower than the surrounding liver parenchyma;The ADC values between ≤3 cm nonepithelial and liver parenchyma around has no significant differences.ADC values of liver parenchyma with liver cirrhosis was lower than that without cirrhosis.Conclusion The existence of mature adipose tissue,the MRI enhancement pattern and the value of ADC can help to distinguish between ≤3 cm nonepithelial HAML and SHCC,then improve the preoperative diagnostic accuracy.
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Objective To analyze the imaging features of hepatic angiomyolipoma (HAML) on computed tomography (CT) and magnetic resonance imaging (MRI).Methods The imaging fingdings of 18 tumors which were pathologically diagnosed as HAML after surgery were analyzed retrospectively.Before operation,twelve and ten patients underwent CT and MRI non-contrast and dynamic enhanced scans,respectively,and 4 patients received both examinations.The imaging characteristics including the number,diameter,location,appearance of the lesions,plain and dynamic enhancement mode were analyzed.Results Eighteen HAML lesions were found in 18 patients with a diameter ranging from 1.5 cm to 17.2 cm (mean 5.3 cm).Five lesions manifested fatty content,and one showed hemorrhage and necrosis.Five HAMLs enhanced in a fast-in and fast-out mode,eleven in a fast-in and slow-out mode and two other lesions in an irregularly discrete mode.The arterial supply was found in 11 HAMLs in the hepatic arterial phase,all coming from intrahepatic arteries.Intratumoral vessels were observed in 12 HAMLs.Early draining veins to the hepatic vein (n =3) and portal vein (n =1) were detected in 4 HAMLs.One lesion demonstrated delayed enhancement in the pseudocapsule.Conclusion The detection of arterial supply and intratumoral vessels in a hypervascular hepatic tumor on contrast CT and MRI in a patient with a non-cirrhotic liver and normal AFP helps to make a diagnosis of HAML.
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Objective To investigate the clinical features and prognosis of hepatic angiomyolipoma(HAML). Methods Clinical data of 13 patients with operatively confirmed HAML treated in our hospital were retrospectively analyzed. Results HAML was usually asymptomatic and the imaging features varied. Only 1 case was correctly diagnosed before operation. HMB45 positive staining was the pathologic characteristic of HAML. Conclusion HAML can be easily misdiagnosed, should be properly treated by surgery and has a good prognosis.
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Hepatic angiomyolipoma (AML) is a very rare neoplasm compared to that of the kidney. Few of these occurred in symptomatic patients and showed intratumoral hemorrhagic foci. The spontaneous rupture of AML is a rare complication that occurs most commonly in the kidney. Only two cases of spontaneous rupture of hepatic AML treated surgically have been published. We now report a case of a 39-year-old woman with chronic hepatitis B and spontaneous rupture of hepatic AML mimicking hepatocellular carcinoma, which was successfully treated by transcather arterial chemoembolization. To our knowledge, this is the first reported case of ruptured hepatic AML treated successfully by transarterial embolization.
Subject(s)
Adult , Female , Humans , Angiomyolipoma , Carcinoma, Hepatocellular , Hepatitis B, Chronic , Kidney , Rupture, SpontaneousABSTRACT
Objective To evaluate imaging diagnosis, differential diagnosis, surgery and interventional therapy of hepatic angiomyolipoma associated with tuberous sclerosis.Methods Clinical features, imaging appearances and interventional therapy for 2 cases of HAML in TS were retrospectrively analyzed. Results The features of HAML in TS are as following:(1) Two cases were female with no history of hepatitis and hepatocirrhosis, liver function test and alpha feto protein were normal. (2) the tumor was shown as a multiple hyperechoic mass with sharp margin on ultrasonography; well defined, fat density and intensity mass on computerized tomography (CT); hypervascular mass with early drainage of hepatic vein and tumor staining on angiography. (3) One case underwent interventional therapy. After 42 month follow up, the tumor was found to be diminished in size. Another case was under monitored with only the enucleating of left renal mass. The hepatic tumor showed no change after 10 months.Conclusions The imaging appearances of HAML in TS are relatively characteristic. Superselective arterial embolization is an effective treatment for HAML in TS.